Food Politics: How the Food Industry Influences Nutrition and Health, Revised and Expanded Tenth...

HOW THE FOOD INDUSTRY INFLUENCES NUTRIT ION AND HEALTH

Revised and Expanded Edition

MARION NESTLE

UNIVERSITY OF CALIFORNIA PRESS

Berkeley Los Angeles London

foodPOLITICS

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CONTENTS

Preface to the 2007 Edition vii

Preface to the First Edition xiii

Introduction: The Food Industry and “Eat More” 1

PART ONEIUNDERMINING DIETARY ADVICE 29

1. From “Eat More” to “Eat Less,” 1900–1990 31

2. Politics versus Science: Opposing the Food Pyramid, 1991–1992 51

3. “Deconstructing” Dietary Advice 67

PART TWOIWORKING THE SYSTEM 93

4. Influencing Government: Food Lobbies and Lobbyists 95

5. Co-opting Nutrition Professionals 111

6. Winning Friends, Disarming Critics 137

7. Playing Hardball: Legal and Not 159

PART THREEIEXPLOITING KIDS, CORRUPTING SCHOOLS 173

8. Starting Early: Underage Consumers 175

9. Pushing Soft Drinks: “Pouring Rights” 197

PART FOURIDEREGULATING DIETARY SUPPLEMENTS 219

10. Science versus Supplements: “A Gulf of MutualIncomprehension” 222

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11. Making Health Claims Legal: The Supplement Industry’sWar with the FDA 247

12. Deregulation and Its Consequences 272

PART FIVEIINVENTING TECHNO-FOODS 295

13. Go Forth and Fortify 298

14. Beyond Fortification: Making Foods Functional 315

15. Selling the Ultimate Techno-Food: Olestra 338

Conclusion: The Politics of Food Choice 358

Afterword: Food Politics: Five Years Later and Beyond 375

Appendix: Issues in Nutrition and Nutrition Research 395

Notes 407

List of Tables 465

List of Figures 467

Index 469

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1

INTRODUCTION THE FOOD INDUSTRY AND “EAT MORE”

this book is about how the food industry influences what we eatand, therefore, our health. That diet affects health is beyond question.The food industry has given us a food supply so plentiful, so varied, soinexpensive, and so devoid of dependence on geography or season that allbut the very poorest of Americans can obtain enough energy and nutrientsto meet biological needs. Indeed, the U.S. food supply is so abundant thatit contains enough to feed everyone in the country nearly twice over—even after exports are considered. The overly abundant food supply,combined with a society so affluent that most people can afford to buymore food than they need, sets the stage for competition. The food indus-try must compete fiercely for every dollar spent on food, and food com-panies expend extraordinary resources to develop and market productsthat will sell, regardless of their effect on nutritional status or waistlines.To satisfy stockholders, food companies must convince people to eatmore of their products or to eat their products instead of those of com-petitors. They do so through advertising and public relations, of course,but also by working tirelessly to convince government officials, nutritionprofessionals, and the media that their products promote health—or atleast do no harm. Much of this work is a virtually invisible part of con-temporary culture that attracts only occasional notice.

This book exposes the ways in which food companies use politicalprocesses—entirely conventional and nearly always legal—to obtain gov-ernment and professional support for the sale of their products. Itstwofold purpose is to illuminate the extent to which the food industry

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determines what people eat and to generate much wider discussion of thefood industry’s marketing methods and use of the political system.

In my 30 years as a nutrition educator, I have found that food industrypractices are discussed only rarely. The reasons for this omission are notdifficult to understand. Most of us believe that we choose foods for rea-sons of personal taste, convenience, and cost; we deny that we can bemanipulated by advertising or other marketing practices. Nutrition scien-tists and practitioners typically believe that food companies are genuinelyinterested in improving health. They think it makes sense to work withthe industry to help people improve their diets, and most are outraged bysuggestions that food industry sponsorship of research or programsmight influence what they do or say. Most food company officials main-tain that any food product can be included in a balanced, varied, andmoderate diet; they say that their companies are helping to promote goodhealth when they fund the activities of nutrition professionals. Most offi-cials of federal agriculture and health agencies understand that their unitsare headed by political appointees whose concerns reflect those of thepolitical party in power and whose actions must be acceptable to Con-gress. Members of Congress, in turn, must be sensitive to the concerns ofcorporations that help fund their campaigns.

In this political system, the actions of food companies are normal,legal, and thoroughly analogous to the workings of any other majorindustry—tobacco, for example—in influencing health experts, federalagencies, and Congress.1 Promoting food raises more complicated issuesthan promoting tobacco, however, in that food is required for life andcauses problems only when consumed inappropriately. As this book willdemonstrate, the primary mission of food companies, like that of tobaccocompanies, is to sell products. Food companies are not health or socialservice agencies, and nutrition becomes a factor in corporate thinkingonly when it can help sell food. The ethical choices involved in suchthinking are considered all too rarely.

Early in the twentieth century, when the principal causes of death anddisability among Americans were infectious diseases related in part toinadequate intake of calories and nutrients, the goals of health officials,nutritionists, and the food industry were identical—to encourage peopleto eat more of all kinds of food. Throughout that century, improvementsin the U.S. economy affected the way we eat in important ways: Weobtained access to foods of greater variety, our diets improved, and nutri-ent deficiencies gradually declined. The principal nutritional problemsamong Americans shifted to those of overnutrition—eating too much

2 . INTRODUCTION


food or too much of certain kinds of food. Overeating causes its own setof health problems; it deranges metabolism, makes people overweight,and increases the likelihood of “chronic” diseases—coronary heart dis-ease, certain cancers, diabetes, hypertension, stroke, and others—thatnow are leading causes of illness and death in any overfed population.

People may believe that the effects of diet on chronic disease are lessimportant than those of cigarette smoking, but each contributes to aboutone-fifth of annual deaths in the United States. Addressing cigarettesmoking requires only a single change in behavior: Don’t smoke. Butbecause people must eat to survive, advice about dietary improvements ismuch more complicated: Eat this food instead of that food, or eat less. Asthis book explains, the “eat less” message is at the root of much of thecontroversy over nutrition advice. It directly conflicts with food industrydemands that people eat more of their products. Thus food companieswork hard to oppose and undermine “eat less” messages.

I first became aware of the food industry as an influence on govern-ment nutrition policies and on the opinions of nutrition experts when Imoved to Washington, DC, in 1986 to work for the Public Health Ser-vice. My job was to manage the editorial production of the first—and asyet only—Surgeon General’s Report on Nutrition and Health, whichappeared as a 700-page book in the summer of 1988.2 This report was anambitious government effort to summarize the entire body of researchlinking dietary factors such as fat, saturated fat, cholesterol, salt, sugar,and alcohol to leading chronic diseases. My first day on the job, I wasgiven the rules: No matter what the research indicated, the report couldnot recommend “eat less meat” as a way to reduce intake of saturated fat,nor could it suggest restrictions on intake of any other category of food.In the industry-friendly climate of the Reagan administration, the pro-ducers of foods that might be affected by such advice would complain totheir beneficiaries in Congress, and the report would never be published.

This scenario was no paranoid fantasy; federal health officials hadendured a decade of almost constant congressional interference with theirdietary recommendations. As I discuss in Part I, agency officials hadlearned to avoid such interference by resorting to euphemisms, focusingrecommendations on nutrients rather than on the foods that containthem, and giving a positive spin to any restrictive advice about food.Whereas “eat less beef” called the industry to arms, “eat less saturatedfat” did not. “Eat less sugar” sent sugar producers right to Congress, butthat industry could live with “choose a diet moderate in sugar.” Whenreleased in 1988, the Surgeon General’s Report recommended “choose

3 . INTRODUCTION


lean meats” and suggested limitations on sugar intake only for peopleparticularly vulnerable to dental cavities.

Subsequent disputes have only reinforced sensitivities to political expe-diency when formulating advice about diet and health. Political expedi-ency explains in part why no subsequent Surgeon General’s Report hasappeared, even though Congress passed a law in 1990 requiring that onebe issued biannually. After ten years of working to develop a SurgeonGeneral’s Report on Dietary Fat and Health—surely needed to help peo-ple understand the endless debates about the relative health consequencesof eating saturated, monounsaturated, trans-saturated, and total fat—thegovernment abandoned the project, ostensibly because the science basehad become increasingly complex and equivocal. A more compelling rea-son must have been lack of interest in completing such a report in theelection year of 2000. Authoritative recommendations about fat intakewould have had to include some “eat less” advice if for no other reasonthan because fat is so concentrated in calories—it contains 9 calories pergram, compared to 4 each for protein or carbohydrate3—and obesity is amajor health concern. Because saturated fat and trans-saturated fat raiserisks for heart disease, and the principal sources of such fats in Americandiets are meat, dairy, cooking fats, and fried, fast, and processed foods,“eat less” advice would provoke the producers and sellers of these foodsto complain to their friends in Congress.

Since 1988, in my role as chair of an academic department of nutri-tion, a member of federal advisory committees, a speaker at public andprofessional meetings, a frequent commentator on nutrition issues to thepress, and (on occasion) a consultant to food companies, I have becomeincreasingly convinced that many of the nutritional problems of Ameri-cans—not least of them obesity—can be traced to the food industry’simperative to encourage people to eat more in order to generate sales andincrease income in a highly competitive marketplace. Ambiguous dietaryadvice is only one result of this imperative. As I explain in Part II, theindustry also devotes enormous financial and other resources to lobbyingCongress and federal agencies, forming partnerships and alliances withprofessional nutrition organizations, funding research on food and nutri-tion, publicizing the results of selected research studies favorable toindustry, sponsoring professional journals and conferences, and makingsure that influential groups—federal officials, researchers, doctors, nurses,school teachers, and the media—are aware of the benefits of their products.

Later sections of the book describe the ways in which such actionsaffect food issues of particular public interest and debate. Part III reviews

4 . INTRODUCTION


the most egregious example of food company marketing practices: thedeliberate use of young children as sales targets and the conversion ofschools into vehicles for selling “junk” foods high in calories but low innutritional value. Part IV explains how the supplement industry manipu-lated the political process to achieve a sales environment virtually free ofgovernment oversight of the content, safety, and advertising claims for itsproducts. In Part V, I describe how the food industry markets “junk”foods as health foods by adding nutrients and calling them “functional”foods or “nutraceuticals.” The concluding chapter summarizes the signif-icance of the issues raised by these examples and offers some options forchoosing a healthful diet in an overabundant food system. Finally, theAppendix introduces some terms and concepts used in the field of nutri-tion and discusses issues that help explain why nutrition research is socontroversial and so often misunderstood.

Before plunging into these accounts, some context may prove useful.This introduction addresses the principal questions that bear on the mat-ters discussed in this book: What are we supposed to eat to stay healthy?Does diet really matter? Is there a significant gap between what we aresupposed to eat and what we do eat? The answers to these questions con-stitute a basis for examining the central concern of this book: Does thefood industry have anything to do with poor dietary practices? As a back-ground for addressing that question, this introduction provides some fun-damental facts about today’s food industry and its marketing philoso-phies and strategies, and also points to some common themes that appearthroughout the book.

WHAT IS A “HEALTHY” DIET?

To promote health as effectively as possible, diets must achieve balance:They must provide enough energy (calories) and vitamins, minerals, andother essential nutrients to prevent deficiencies and support normalmetabolism. At the same time, they must not include excessive amountsof these and other nutritional factors that might promote development ofchronic diseases. Fortunately, the optimal range of intake of most dietarycomponents is quite broad (see the Appendix). It is obvious that peoplethroughout the world eat many different foods and follow many differentdietary patterns, many of which promote excellent health and longevity.As with other behavioral factors that affect health, diet interacts withindividual genetic variation as well as with cultural, economic, and geo-graphical factors that affect infant survival and adult longevity. On a

5 . INTRODUCTION


population basis, the balance between getting enough of the right kindsof nutrients and avoiding too much of the wrong kinds is best achievedby diets that include large proportions of energy from plant foods—fruits, vegetables, and grains.

The longest-lived populations in the world, such as some in Asia andthe Mediterranean, traditionally eat diets that are largely plant-based.Such diets tend to be relatively low in calories but high in vitamins, minerals, fiber, and other components of plants (phytochemicals) that—acting together—protect against disease. Dietary patterns that best pro-mote health derive most energy from plant foods, considerably less fromfoods of animal origin (meat, dairy, eggs), and even less from foods highin animal fats and sugars. The Food Guide Pyramid of the U.S. Depart-ment of Agriculture (USDA) is meant to depict a plant-based diet that

6 . INTRODUCTION

FIGURE 1. The 1992 USDA Food Guide Pyramid recommends a hierarchical—and therefore controversial—dietary pattern based mainly on foods of plantorigin, as discussed in Part I.


promotes optimal health (see Figure 1). Chapter 2 describes the extent towhich this Pyramid fails to illustrate an optimal dietary pattern, however,and explains the food industry’s role in that failure.

DOES DIET MATTER?

In addition to consuming largely plant-based diets, people in long-livedpopulations are physically active and burn up any excess calories theyobtain from food. An active lifestyle helps mitigate the harmful effects ofovereating, but the evidence for the importance of diet in health also isoverwhelming. Disease by chronic disease, scientists consistently havedemonstrated the health benefits of diets rich in fruit and vegetables, lim-ited in foods and fats of animal origin, and balanced in calories. Compre-hensive reports in the late 1980s from the United States and Europe doc-umented the evidence available at that time, and subsequent research hasonly strengthened those conclusions.4

Health experts suggest conservatively that the combination of poordiet, sedentary lifestyle, and excessive alcohol consumption contributesto about 400,000 of the 2,000,000 or so annual deaths in the UnitedStates—about the same number and proportion affected by cigarettesmoking. Women who follow dietary recommendations display half therates of coronary heart disease observed among women who eat poordiets, and those who also are active and do not smoke cigarettes have lessthan one-fifth the risk. The diet-related medical costs for just six healthconditions—coronary heart disease, cancer, stroke, diabetes, hyperten-sion, and obesity—exceeded $70 billion in 1995. Some authoritiesbelieve that just a 1% reduction in intake of saturated fat across the pop-ulation would prevent more than 30,000 cases of coronary heart diseaseannually and save more than a billion dollars in health care costs. Suchestimates indicate that even small dietary changes can produce large ben-efits when their effects are multiplied over an entire population.5

Conditions that can be prevented by eating better diets have roots inchildhood. Rates of obesity are now so high among American childrenthat many exhibit metabolic abnormalities formerly seen only in adults.The high blood sugar due to “adult-onset” (insulin-resistant type 2) dia-betes, the high blood cholesterol, and the high blood pressure nowobserved in younger and younger children constitute a national scandal.Such conditions increase the risk of coronary heart disease, cancer,stroke, and diabetes later in life. From the late 1970s to the early 1990s,the prevalence of overweight nearly doubled—from 8% to 14% among

7 . INTRODUCTION


children aged 6–11 and from 6% to 12% among adolescents. The pro-portion of overweight adults rose from 25% to 35% in those years. Justbetween 1991 and 1998, the rate of adult obesity increased from 12% tonearly 18%. Obesity contributes to increased health care costs, therebybecoming an issue for everyone, overweight or not.6

The cause of overweight is an excess of calories consumed over calo-ries burned off in activity. People gain weight because they eat too manycalories or are too inactive for the calories they eat. Genetics affects thisbalance, of course, because heredity predisposes some people to gainweight more easily than others, but genetic changes in a population occurtoo slowly to account for the sharp increase in weight gain over such ashort time period. The precise relationship between the diet side and theactivity side of the weight “equation” is uncertain and still under investi-gation, in part because we lack accurate methods for assessing the activ-ity levels of populations. People seem to be spending more time at seden-tary activities such as watching television and staring at computerscreens, and the number of hours spent watching television is one of thebest predictors of overweight, but surveys do not report enough of adecrease in activity levels to account for the current rising rates of obe-sity.7 This gap leaves overeating as the most probable cause of excessiveweight gain.

DO AMERICANS OVEREAT?

Overweight itself constitutes ample evidence that many Americans con-sume more calories than they burn off, but other sources of informationalso confirm the idea that people are eating too much food. The caloriesprovided by the U.S. food supply increased from 3,200 per capita in 1970to 3,900 in the late 1990s, an increase of 700 per day. These supply fig-ures tend to overestimate amounts of food actually consumed becausethey do not account for wastage, but they do give some indication oftrends (see the Appendix). Surveys that ask about actual dietary intaketend to underestimate caloric intake, because people find it difficult toremember dietary details, but easier to give answers that seem to pleaseinvestigators. Even so, dietary intake surveys also indicate that people areeating more than they were in the 1970s. Then, people reported eating anaverage of about 1,800 calories per day. By 1996 they reported 2,000calories per day. No matter how unrealistically low these figures may beand how imprecise the sources of data, all suggest a trend toward caloricintakes that exceed average levels of caloric expenditure.8

8 . INTRODUCTION


In addition to revealing how much people are eating, food supply anddietary intake surveys indicate changes in food habits over time. Theincrease in calories reflects an increase in consumption of all major foodgroups: more vegetables and more fruit (desirable), but also more meatand dairy foods, and more foods high in fat and sugar (less desirable).The most pronounced change is in beverage consumption. The supply ofwhole milk fell from 25.5 gallons per capita per year in 1970 to just 8.5gallons in 1997. The supply of low-fat milk rose from 5.8 to 15.5 gallonsduring the same time, but that of soft drinks rose from 24.3 to 53 gallons.To reduce fat intake, people replaced whole milk with lower-fat varieties(same nutrients, fewer calories), but they undermined this beneficialchange by increasing consumption of soft drinks (sugar calories, no nutri-ents). Despite the introduction of artificial sweeteners, the supply of calo-rie-laden sweeteners—sugars, corn sweeteners, and honey—has gone up.Because of the inconsistencies in data, the trend in fat intake is harder todiscern. Fat in the food supply increased by 25% from 1970 to the late1990s, but dietary intake surveys do not find people to be eating more ofit. Although USDA nutritionists conclude that Americans are eating lessfat, they also observe that people are eating more food outside the home,where foods are higher in fat and calories.9

In comparison to the Pyramid, American diets clearly are out of bal-ance, as shown in Figure 2. Top-heavy as it is, this illustration underesti-mates the discrepancy between recommended and actual servings. Forone thing, the USDA’s serving estimates are based on self-reports ofdietary intake, but people tend to underreport the intake of foods consid-ered undesirable and to overestimate the consumption of “healthy”foods. For another, the USDA calculates numbers of servings by addingup the individual components of mixed dishes and assigning them to theappropriate Pyramid categories. This means that the flour in cookies isassigned to the grain category, the apples in pies to the fruit group, andthe potatoes in chips to the vegetable group. This method may yield moreprecise information about nutrient intake, but it makes high-calorie, low-nutrient foods appear as better nutritional choices than they may be. Theassignment of the tomatoes in ketchup to the vegetable group only rein-forces the absurdity of the USDA’s famous attempt during the Reaganadministration to count ketchup as a vegetable in the federal schoollunch program.10

The comparison hides other unwelcome observations. USDA nutri-tionists report that the average consumption of whole-grain foods is justone serving per day, well below recommended levels. And although the

9 . INTRODUCTION


number of vegetable servings appears close to recommendations, half theservings come from just three foods: iceberg lettuce, potatoes (frozen,fresh, and those used for chips and fries), and canned tomatoes. Whenfried potatoes are excluded from the count, vegetable servings fall belowthree per day. Even though the consumption of reduced-fat dairy prod-ucts has doubled since 1970, half the dairy servings still come from high-fat, high-calorie cheese and whole milk. Servings of added fats are at leastone-third higher than they should be, and servings of caloric sweetenersare half again as high. From such observations, we can conclude that theincreased calories in American diets come from eating more food in gen-eral, but especially more of foods high in fat (meat, dairy, fried foods,grain dishes with added fat), sugar (soft drinks, juice drinks, desserts),and salt (snack foods).11 It can hardly be a coincidence that these are just

10 . INTRODUCTION

FIGURE 2. This “food consumption” pyramid compares the average number of servings consumed per day by the U.S. population in the mid-1990s to theservings recommended by the Food Guide Pyramid. (Courtesy NationalCattlemen’s Beef Association)


the foods that are most profitable to the food industry and that it mostvigorously promotes.

THE U.S. FOOD INDUSTRY

This book uses the term food industry to refer to companies that pro-duce, process, manufacture, sell, and serve foods, beverages, and dietarysupplements. In a larger sense, the term encompasses the entire collectionof enterprises involved in the production and consumption of food andbeverages: producers and processors of food crops and animals (agribusi-ness); companies that make and sell fertilizer, pesticides, seeds, and feed;those that provide machinery, labor, real estate, and financial services tofarmers; and others that transport, store, distribute, export, process, andmarket foods after they leave the farm. It also includes the food servicesector—food carts, vending machines, restaurants, bars, fast-food outlets,schools, hospitals, prisons, and workplaces—and associated suppliers ofequipment and serving materials. This vast “food-and-fiber” system gen-erates more than a trillion dollars in sales of food alone every year,accounts for 8% of the U.S. gross national product (GNP), and employs12% of the country’s labor force. Of the $1.1 trillion that the publicspent directly on food and drink in 2005, alcoholic beverages accountedfor about $130 billion, and the rest was distributed among retail foodenterprises (53%) and food service (47%).12

The U.S. food industry is the remarkably successful result of twentieth-century trends that led from small farms to giant corporations, from asociety that cooked at home to one that buys nearly half its meals pre-pared and consumed elsewhere, and from a diet based on “whole” foodsgrown locally to one based largely on foods that have been processed insome way and transported long distances. These changes created a farmsystem that is much less labor-intensive and far more efficient and spe-cialized. In 1900, 40% of the population lived on farms, but today nomore than 2% do. Just since 1960, the number of farms has declinedfrom about 3.2 million to 1.9 million, but their average size has increasedby 40% and their productivity by 82%. Most farms today raise just a single commodity such as cattle, chickens, pigs, corn, wheat, or soybeans.Many are part of a system of “vertical” integration: ownership by onecorporation of all stages of production and marketing. Chickens consti-tute an especially clear example. In the mid-1950s, chickens were raisedin small flocks by many farmers; today, most are “factory-farmed” inmassive numbers under contract to a few large companies.13

11 . INTRODUCTION


Economic pressures force food and beverage companies to expand totremendous size. In 2000, seven U.S. companies—Philip Morris, ConAgra,Mars, IBP, Sara Lee, Heinz, and Tyson Foods—ranked among the tenlargest food companies in the world. Nestlé (Switzerland) ranked first,Unilever (U.K./Netherlands) third, and Danone (France) sixth. Other U.S.

12 . INTRODUCTION

TABLE 1. Sales and advertising expenditures for the ten leading producers ofpackaged food products in the United States

Food Sales [Total Sales], Advertising, U.S., 1998Company and Examples 1999 ($ Billions) ($ Millions)

Nestlé 34.9 [49.4] 534.4Carnation foods 31.1Lean Cuisine 16.4Butterfinger candy 11.2

Unilever/Bestfoods* 32.4 [55.3]Unilever 1,015.0Lipton’s tea beverages 41.8Wish-Bone salad dressing 15.2Bestfoods 202.5Thomas’ English muffins 9.5Skippy peanut butter 4.0

Philip Morris 27.8 [78.6] 2,049.3Kraft Foods, Inc. 146.1Jell-O desserts 65.6Altoids mints 10.1

Pepsico 11.6 [18.7] 1,263.4Pepsi and Diet Pepsi 145.2Lay’s potato chips 55.8Tropicana fruit juices 23.3

Groupe Danone 9.8 [14.2] *H.J. Heinz 9.3 214.5Nabisco 8.4 225.7Kellogg 7.7 448.5

Cereals 278.7Eggo frozen waffles 34.3

General Mills* 6.7 597.9Cereals 296.7Fruit-by-the-Foot snacks 10.3

Campbell Soup 6.2 336.8Soups 108.0Pepperidge Farm 37.2

principal sources: Endicott RC. 44th annual 100 leading national advertisers. AdvertisingAge September 27, 1999:s1–s46. Hays CL. New York Times June 7, 2000:C1,C8. Thompson S. Adver-tising Age June 12, 2000:4.

*In 2000, Unilever purchased Bestfoods soon after acquiring Ben & Jerry’s and Slim-Fast. GeneralMills bought the Pillsbury division of Diageo, making the combined company the fifth largest of U.S.foodmakers, with $12.2 billion in annual sales. Danone was not among the top 200 U.S. advertisers in1998, because the company’s principal markets are in Europe.


companies such as Coca-Cola, McDonald’s, PepsiCo, Procter & Gamble,and Roche (vitamins) ranked among the top one hundred companiesworldwide. In the United States alone, just three companies—Philip Morris(Kraft Foods, Miller Brewing), ConAgra, and RJR-Nabisco—accountedfor nearly 20% of all food expenditures in 1997. Table 1 lists the tenleading producers of packaged food products in the United States in2000, along with their annual sales and advertising budgets. The largestcompanies generated more than $30 billion each in annual sales, placinggreat pressure on smaller companies to merge. Such pressures also applyto supermarkets. Mergers among food and cigarette companies meritspecial interest. As described in Table 2, two of the four leading U.S. cig-arette companies, R. J. Reynolds and Philip Morris, bought—and some-times swapped—food and beverage companies in maneuvers designed toprotect stockholders’ investments against tobacco liability lawsuits.

The increasing consumption of food outside the home also has impli-cations for the food industry—and for health. Table 3 lists the leadingU.S. food service companies by category: fast foods, restaurant chains,contract corporations, and hotel operations. The highest-selling foodservice chains are sandwich houses and fast-food chains. First amongthem is McDonald’s; its 12,804 U.S. outlets brought in $19.6 billion in2000 sales, more than twice as much as its nearest competitor.

The greater efficiency, specialization, and size of agriculture and foodproduct manufacture have led to one of the great unspoken secrets aboutthe American food system: overabundance. As already noted, the U.S.food supply—plus imports less exports—provides a daily average of3,900 calories per capita. This level is nearly twice the amount needed tomeet the energy requirements of most women, one-third more than thatneeded by most men, and much higher than that needed by babies, youngchildren, and the sedentary elderly. Even if, as the USDA estimates, 1,100of those calories might be wasted (as spoiled fruit, for example, or as oilfor frying potatoes), the excess calories are a major problem for the foodindustry: they force competition. Even people who overindulge can eatonly so much food, and choosing one food means rejecting others. Over-abundance alone is sufficient to explain why the annual growth rate ofthe American food industry is only a percentage point or two, and why ithas poked along at that low level for many years. It also explains whyfood companies compete so strenuously for consumer food dollars, whythey work so hard to create a sales-friendly regulatory and political cli-mate, and why they are so defensive about the slightest suggestion thattheir products might raise health or safety risks.

13 . INTRODUCTION


TABLE 2. Cigarette companies’ ownership of food and beverage companies:chronology

1969 Philip Morris, Inc. acquires 53% of Miller Brewing.1970 Philip Morris buys the remaining 47% of Miller Brewing.1978 Philip Morris acquires 97% of Seven-Up.1985 R.J. Reynolds buys Nabisco Foods for $4.9 billion, creating RJR-

Nabisco, a public company.Philip Morris buys General Foods for $5.6 billion.

1986 Philip Morris sells Seven-Up to PepsiCo.1988 Philip Morris buys Kraft, Inc. for $13.6 billion. RJR-Nabisco

announces plans to “go private”; offers to buy outstandingpublic shares for $17 billion.

1989 The investment firm Kohlberg Kravis Roberts leverages a buyout of RJR-Nabisco for $24.9 billion, leaving the private company with$20 billion in debt. Philip Morris combines Kraft and GeneralFoods to form Kraft General Foods.

1990 Philip Morris acquires Jacobs Suchard, a Swiss coffee and confectionary company, for $4.1 billion.

1991 Kohlberg Kravis Roberts sells stocks in RJR-Nabisco to the public. The bestseller Barbarians at the Gate (New York: HarperCollins,1991) describes the takeover events.

1993 Kraft General Foods (Philip Morris) buys Nabisco ready-to-eat cereals from RJR-Nabisco for $448 million.

1995 Kraft General Foods reorganizes into Kraft Foods, Inc. In an effort to shore up stock prices, RJR-Nabisco becomes a holdingcompany for R. J. Reynolds (tobacco) and Nabisco Holdings(food); sells 19% of shares in Nabisco Holdings to the public.

1996 Philip Morris buys shares of Brazil’s leading chocolate company, Industrias de Chocolate Lacta, S.A.; Kraft Foods acquires TacoBell.

1999 RJR-Nabisco sells its international tobacco business; separates and renames its domestic tobacco (R. J. Reynolds Tobacco Holdings)and food businesses (Nabisco Group Holdings). This actionleaves Nabisco Group Holdings with 81% of Nabisco as its soleasset (Nabisco Holdings has the remainder), only $1 billion indebt, but with uncertain liability for tobacco lawsuits. Philip Morris said to be interested in buying Nabisco; acquiresPhiladelphia cream cheese; reports revenues exceeding $78 billion.

2000 Philip Morris buys Nabisco Holdings for $14.9 billion, creating a company that earned combined revenues of $34.9 billion andprofits of $5.5 billion in 1999. This purchase leaves R.J.Reynolds Tobacco Holdings with $1.5 billion in cash and thetobacco liability.

2003 Company restructures as Altria, now “parent” to Philip Morris andKraft Foods.

2007 Altria authorizes sale of its Kraft shares.

principal sources: Philip Morris Companies, Inc. Online: http://www.kraftfoods.com/.Accessed February 24, 1999. Hays CL. New York Times March 10, 1999:A1,C8, and July 2,2000:C7. See www.altria.com.


MARKETING IMPERATIVES

To sell their products, companies appeal to the reasons why peoplechoose to eat one food rather than another. These reasons are numerous,complex, and not always understood, mainly because we select dietswithin the context of the social, economic, and cultural environment inwhich we live. When food or money is scarce, people do not have the lux-ury of choice; for much of the world’s population, the first considerationis getting enough food to meet biological needs for energy and nutrients.It is one of the great ironies of nutrition that the traditional plant-baseddiets consumed by the poor in many countries, some of which are among

15 . INTRODUCTION

TABLE 3. Where Americans eat: the top two U.S. food service chain companiesin 2000 sales, by category and number of units

2000 Sales, Chain Category ($ Millions) Number of Units, U.S.

SandwichMcDonald’s 19,573 12,804Burger King 8,695 8,064

PizzaPizza Hut 5,000 7,927Domino’s 2,647 4,818

ChickenKFC (Kentucky Fried Chicken) 4,400 5,364Chick-fil-A 1,082 1,958

Grill BuffetGolden Corral 968 452Ryan’s Family Steak House 745 324

FamilyDenny’s 2,137 1,753International House of Pancakes 1,199 925

Dinner-HouseApplebee’s Neighborhood 2,625 1,251Red Lobster 2,105 629

ContractAramark Global 4,136 2,907LSG/Sky Chefs 1,476 103

Hotel Food ServiceMarriott 1,045 248Hilton 953 228

source: Liddle AJ. Nation’s Restaurant News July 25, 2001:57–132.


the world’s finest cuisines, are ideally suited to meeting nutritional needsas long as caloric intake is adequate. Once people raised on such foodssurvive the hazards of infancy, their diets (and their active lifestyles) sup-port an adulthood relatively free of chronic disease until late in life.14

Also ironic is that once people become better off, they are observed toenter a “nutrition transition” in which they abandon traditional plant-based diets and begin eating more meat, fat, and processed foods. Theresult is a sharp increase in obesity and related chronic diseases. In 2000the number of overweight people in the world for the first time matchedthe number of undernourished people—1.1 billion each. Even in an indus-trialized country such as France, dietary changes can be seen to producerapid increases in the prevalence of chronic disease. In the early 1960s, theFrench diet contained just 25% of calories from fat, but the proportionnow approaches 40% as a result of increased intake of meat, dairy, andprocessed foods. Despite contentions that the French are protected fromheart disease by their wine consumption (a phenomenon known as theFrench Paradox), they are getting fatter by the day and experiencingincreased rates of diabetes and other health consequences of overeatingand overweight. The nutrition transition reflects both taste preferencesand economics. Food animals raised in feedlots eat grains, which makesmeat more expensive to produce and converts it into a marker of prosper-ity. Once people have access to meat, they usually do not return to eatingplant-based diets unless they are forced to do so by economic reversal orare convinced to do so for reasons of religion, culture, or health.15

Humans do not innately know how to select a nutritious diet; we sur-vived in evolution because nutritious foods were readily available for usto hunt or gather. In an economy of overabundance, food companies cansell products only to people who want to buy them. Whether consumerdemands drive food sales or the industry creates such demands is a mat-ter of debate, but much industry effort goes into trying to figure out whatthe public “wants” and how to meet such “needs.” Nearly all research onthis issue yields the same conclusion. When food is plentiful and peoplecan afford to buy it, basic biological needs become less compelling andthe principal determinant of food choice is personal preference. In turn,personal preferences may be influenced by religion and other cultural fac-tors, as well as by considerations of convenience, price, and nutritionalvalue. To sell food in an economy of abundant food choices, companiesmust worry about those other determinants much more than about thenutritional value of their products—unless the nutrient content helps toentice buyers (see Parts IV and V).16 Thus the food industry’s marketing

16 . INTRODUCTION


imperatives principally concern four factors: taste, cost, convenience, and(as we shall see) public confusion.

Taste: Make Foods Sweet, Fat, and Salty

Adults prefer foods that taste, look, and smell good, are familiar, andprovide variety, but these preferences are influenced strongly by familyand ethnic background, level of education, income, age, and gender.When asked, most of us say we choose foods because we like them, bywhich we mean the way we respond to their flavor, smell, sight, and tex-ture. Most of us prefer sweet foods and those that are “energy-dense”(high in calories, fat, and sugar), and we like the taste of salt. The univer-sality of such preferences suggests some physiologic basis for all of them,but the research is most convincing for sweetness. Ripe fruit is innatelysweet and appealing, but many of us can and do learn to enjoy the com-plex and sometimes bitter taste of vegetables. Whether a taste for meat isinnate or acquired can be debated, but many people like to eat steak,hamburgers, and fried chicken, along with desserts, soft drinks, and saltysnacks. Such preferences drive the development of new food products aswell as the menus in restaurants.

Cost: Add Value but Keep Prices Low

One result of overabundance is pressure to add value to foods throughprocessing. The producers of raw foods receive only a fraction of theprice that consumers pay at the supermarket. In 1998, for example, anaverage of 20% of retail cost—the “farm value” of the food—wasreturned to its producers. This percentage, which has been declining foryears, is unequally distributed. Producers of eggs, beef, and chickenreceive 50% to 60% of retail cost, whereas producers of vegetablesreceive as little as 5%. Once foods get to the supermarket, the proportionrepresented by the farm value declines further in proportion to the extentof processing. The farm value of frozen peas is 13%, of canned tomatoes9%, of oatmeal 7%, and of corn syrup just 4%.17

As shown in Figure 3, the remaining 80% of the food dollar goes forlabor, packaging, advertising, and other such value-enhancing activities.Conversion of potatoes (cheap) to potato chips (expensive) to those friedin artificial fats or coated in soybean flour or herbal supplements (evenmore expensive) is an example of how value is added to basic food com-modities. Added value explains why the cost of the corn in Kellogg’s

17 . INTRODUCTION


Corn Flakes is less than 10% of the retail price. With this kind of pricingdistribution, food companies are more likely to focus on developingadded-value products than to promote consumption of fresh fruits andvegetables, particularly because opportunities for adding value to suchfoods are limited. Marketers can add value to fruits and vegetables byselling them frozen, canned, or precut, but even the most successful of suchproducts—prepackaged and branded “baby” carrots, salad mixes, andprecut fruit—raise consumer concerns about freshness, safety, and price.

Despite the focus on adding value, overabundance keeps food costslow compared to those anywhere else in the world, and this is due only inpart to our high average income. The average American pays less than10% of income for food. People in low-income countries like Tanzaniapay more than 70% of income for food, and those in middle-incomecountries like the Philippines up to 55%, but even people in high-incomecountries like Japan pay as much as 20%. Americans, however, stronglyresist price increases. In the United States, lower prices stimulate sales,especially the sale of higher-cost items; price is a more important factor inthe consumer’s choice of steak than of ground beef. Cost is so importanta factor in food choice that economists are able to calculate the effect of achange in price on nutrient intake. They estimate that a decline in theprice of meat, for example, causes the average intake of calcium and ironto rise but also increases the consumption of calories, fat, saturated fat,and cholesterol.18

18 . INTRODUCTION

FIGURE 3. The distribution of the U.S. food dollar: 80% of food expendituresgo to categories other than the “farm value” of the food itself. (Source: USDAFoodReview 2000;23(3):27–30)

Labo

r

Packa

ging

Tran

spor

tatio

n

Energ

y

Profits

Adver

tising

Depre

ciatio

n

Rent

Inte

rest

Repair

s

Busine

ss ta

xes

Other

costs

Farm value Marketing bill

20¢ 39¢ 8.0¢ 4.0¢ 3.5¢ 4.0¢ 4.0¢ 3.5¢ 4.0¢ 2.5¢ 1.5¢ 3.5¢ 2.5¢


A more important reason for low food prices is that the governmentsubsidizes food production in ways that are rarely evident. The most vis-ible subsidies are price supports for sugar and milk, but taxpayers alsosupport production quotas, market quotas, import restrictions, deficiencypayments, lower tax rates, low-cost land leases, land management, waterrights, and marketing and promotion programs for major food com-modities. The total cost of agricultural subsidies rose rapidly at the end ofthe twentieth century from about $18 billion in 1996 to $28 billion in2000. As we shall see in Part II, the large agricultural corporations thatmost benefit from federal subsidies spare no effort to persuade Congressand the administration to continue and increase this largesse.19

Convenience: Make Eating Fast

Convenience is a principal factor driving the development of value-addedproducts. The demographic causes of demands for convenience are wellunderstood. In the last quarter of the twentieth century, the proportion ofwomen with children who entered the work force greatly expanded, andmany people began to work longer hours to make ends meet. In 1900,women accounted for 21% of the labor force, and married women forless than 6%, but by 1999, women—married or not—accounted formore than 60%. The structure of American families changed once therewas no longer a housewife who stayed home and cooked. Workingwomen were unable or unwilling to spend as much time grocery shop-ping, cooking, and cleaning up after meals.20

Societal changes easily explain why nearly half of all meals are con-sumed outside the home, a quarter of them as fast food, and the practiceof snacking nearly doubled from the mid-1980s to the mid-1990s. Theyexplain the food industry’s development of prepackaged sandwiches, sal-ads, entrees, and desserts, as well as such innovations as “power” bars,yogurt and pasta in tubes, prepackaged cereal in a bowl, salad bars, hot-food bars, take-out chicken, supermarket “home meal replacements,”McDonald’s shaker salads, chips prepackaged with dips, and foodsdesigned to be eaten directly from the package. Whether these “hyper-convenient” products will outlast the competition remains to be seen, butsurvival is more likely to depend on taste and price than on nutrient con-tent. Many of these products are high in calories, fat, sugar, or salt but aremarketed as nutritious because they contain added vitamins (see Part V).

Nutritionists and traditionalists may lament such developments,because convenience overrides not only considerations of health but also

19 . INTRODUCTION


the social and cultural meanings of meals and mealtimes. Many foodproducts relegate cooking to a low-priority chore and encourage trendstoward one-dish meals, fewer side dishes, fewer ingredients, larger por-tions to create leftovers, almost nothing cooked “from scratch,” andhome-delivered meals ordered by phone, fax, or Internet. Interpreting themeaning of these developments no doubt will occupy sociologists andanthropologists for decades. In the meantime, convenience adds value tofoods and stimulates the food industry to create even more products thatcan be consumed quickly and with minimal preparation.

Confusion: Keep the Public Puzzled

Many people find it difficult to put nutrition advice into practice, notleast because they view the advice as ephemeral—changing from one dayto the next. This view is particularly unfortunate because, as I explain inPart I, advice to eat more fruits and vegetables and to avoid overweight asa means to promote health has remained constant for half a century.Confusion about nutrition is quite understandable, however. Peopleobtain information about diet and health from the media—newspapers,magazines, television, radio and more recently the Internet. These outletsget much of their information from research publications, experts, andthe public relations representatives of food and beverage companies.Media outlets require news, and reporters are partial to breakthroughs,simple take-home lessons, and controversies. A story about the benefitsof single nutrients can be entertaining, but “eat your veggies” is old news.It is more interesting to read about a study “proving” that calcium doesor does not prevent bone loss than a report that patiently explains theother factors—nutrients, foods, drinks, exercise—that might influencecalcium balance in the body. Although foods contain hundreds of nutri-ents and other components that influence health, and although people eatdiets that contain dozens of different foods, reporters rarely discuss studyresults in their broader dietary context.21 News outlets are not alone infocusing on single nutrients or foods; researchers also do so. It is easier tostudy the effects of vitamin E on heart disease risk than it is to try toexplain how current dietary patterns are associated with declining ratesof coronary heart disease. Research on the effects of single nutrients ismore likely to be funded, and the results are more likely to garner head-lines, especially if they conflict with previous studies. In the meantime,basic dietary advice remains the same—constant, but dull.

20 . INTRODUCTION


Newspaper sales and research grants may benefit from confusion overdietary advice, but the greatest beneficiary of public confusion is the foodindustry. Part II explains how virtually every food and beverage productis represented by a trade association or public relations firm whose job itis to promote a positive image of that item among consumers, profes-sionals, and the media. These groups—and their lobbyists—can takeadvantage of the results of single-nutrient research to claim that productscontaining the beneficial nutrient promote health and to demand theright to make that claim on package labels. If people are confused aboutnutrition, they will be more likely to accept such claims at face value. It isin the interest of food companies to have people believe that there is nosuch thing as a “good” food (except when it is theirs); that there is nosuch thing as a “bad” food (especially not theirs); that all foods (espe-cially theirs) can be incorporated into healthful diets; and that balance,variety, and moderation are the keys to healthful diets—which meansthat no advice to restrict intake of their particular product is appropriate.The 1992 Pyramid, however, clearly indicated that some foods are betterthan others from the standpoint of health.

PROMOTING “EAT MORE”

In a competitive food marketplace, food companies must satisfy stock-holders by encouraging more people to eat more of their products. Theyseek new audiences among children, among members of minority groups,or internationally. They expand sales to existing as well as new audiencesthrough advertising but also by developing new products designed torespond to consumer “demands.” In recent years, they have embraced anew strategy: increasing the sizes of food portions. Advertising, newproducts, and larger portions all contribute to a food environment thatpromotes eating more, not less.

Advertise, Advertise, Advertise

Advertising operates so far below the consciousness of everyone—thepublic, most nutritionists I know, and survey researchers—that it hardlyever gets mentioned as an influence on food choice. The subliminalnature of food and beverage advertising is a tribute to its ubiquity, as wellas to the sophistication of the agencies that produce it. Extraordinaryamounts of money and talent go into this effort. Food and food service

21 . INTRODUCTION


companies spend more than $11 billion annually on direct media adver-tising in magazines, newspapers, radio, television, and billboards. Someexamples of expenditures by specific companies are given in Table 1. In1999 McDonald’s spent $627.2 million, Burger King $403.6 million,Taco Bell $206.5 million, and Coke and Diet Coke $174.4 million ondirect media advertising. Even small products have impressive advertisingbudgets, as illustrated by expenditures of $117 million for Wrigley’schewing gum and nearly $80 million for M&M candies.22 For every dol-lar spent that “measured” way, the companies spend another two dol-lars on discount incentives—for example, coupons for consumers and“slotting fees” for retailers to ensure space on supermarket shelves. Intotal, food companies spent more than $33 billion annually at the turnof the century to advertise and promote their products to the public.Most of this astronomical sum is used to promote the most highlyprocessed, elaborately packaged, and fast foods. Nearly 70% of foodadvertising is for convenience foods, candy and snacks, alcoholic bever-ages, soft drinks, and desserts, whereas just 2.2% is for fruits, vegeta-bles, grains, or beans.23 Figure 4 illustrates the disproportionate distri-bution of marketing expenditures relative to dietary recommendations.Although the costs of marketing may appear huge, they amount to justa small fraction of sales.

Advertising costs for any single, nationally distributed food productfar exceed (often by 10 to 50 times) federal expenditures for promotionof the Pyramid or to encourage people to eat more fruit and vegetables.Of the more than $300 million that the USDA spends annually on nutri-tion education, most goes for research projects, the educational compo-nents of agricultural extension, and other activities that target relativelyfew people. Despite protestations by marketers that advertising is a minorelement in food choice and that the ubiquity of advertising dilutes itsimpact, they continue to use it to sell products. Successful campaigns arecarefully researched, targeted to specific groups, and repeated frequently.Advertising promotes the sales of specific food products and in propor-tion to the amount spent, as shown for commodities such as milk, cheese,grapefruit juice, and orange juice. Food sales increase with the intensity,repetition, and visibility of the advertising message.24 Promotion of nutri-tional advantages (low-fat, no cholesterol, high-fiber, calcium-added)increases sales, as does the use of health claims (lowers cholesterol, pre-vents cancer). Cigarette company-owned food advertisers are particularlyadept at using charity to sell food products, as shown in Figure 5. Advertis-ing sells food to children, a phenomenon well understood by advertisers

22 . INTRODUCTION


of tobacco and beer. As discussed in Part III, advertisers deliberatelypromote food brands among children and more active demands foradvertised foods.

Introduce New Products

To food and beverage companies, added value and convenience are driv-ing forces for new-product development. Whether the industry createsnew products in response to consumer demand or generates demand by

23 . INTRODUCTION

FIGURE 4. The Produce for Better Health Foundation, a government–industrypartnership to promote consumption of fruits and vegetables, created this “food marketing” pyramid to illustrate the disproportionate expenditure ofadvertising dollars in comparison to dietary recommendations. (CourtesyElizabeth Pivonka, ©Produce for Better Health Foundation, Wilmington, DE)

5 a day–for Better Health!

eat fru

its & vegetables


FIGURE 5. This Philip Morris advertisement for its philanthropic food donationsappeared in Walking, a health and fitness magazine aimed at young women, inOctober 2000. No advertisements for cigarettes appear in the magazine. PhilipMorris owns Kraft Foods and Miller Beer.


creating the products is difficult to untangle; most likely, both interact.Regardless, new-product introductions have increased greatly since themid-1980s when there were fewer than 6,000 annually. In the peak yearof 1995, manufacturers introduced 16,900 food and beverage products,but the number has since declined. All told, 116,000 packaged foods andbeverages have been introduced since 1990, and these joined a market-place that now contains 320,000 items competing for supermarket shelfspace large enough to hold just 50,000.12 The glut of food productsmeans that only the most highly promoted products will succeed; eventhese may encounter difficulties if they do not taste good, raise ques-tions about health or safety, or cost too much.

In 1998, manufacturers introduced slightly more than 11,000 newproducts (Table 4). More than two-thirds of those products are condi-ments, candy and snacks, baked goods, soft drinks, and dairy products(cheese products and ice cream novelties)—foods largely allocated tothe top of the Pyramid. Slightly more than one-fourth are “nutritionallyenhanced” so that they can be marketed as low in fat, cholesterol, salt,or sugar or as higher in fiber, calcium, or vitamins. Some such products,among them no-fat cookies, vitamin-enriched cereals, and calcium-fortified juice drinks, contain so much sugar that they belong at thetop of the Pyramid. Developing such foods has only one purpose: toattract sales.

25 . INTRODUCTION

TABLE 4. Major categories of the 11,037 new foodproducts introduced in 1998

Product Category Number of New Products

Candy, gum, snacks 2,065Condiments 1,994Beverages 1,547Bakery foods 1,178Dairy foods 940Processed meats 728Entrees, pre-prepared 678Fruits and vegetables 375Soups 299Desserts 117Pet foods 105Breakfast cereals 84Baby foods 35

source: Gallo AE. FoodReview 1999;22(3):27–29.


Serve Larger Portions

“Eat more” marketing methods extend beyond billboards and televisioncommercials; they also include substantial increases in the sizes of foodpackages and restaurant portions. When the Pyramid recommends 6 to11 grain servings, these amounts seem impossibly large with reference torestaurant, fast, or take-out foods. The Pyramid serving numbers, how-ever, refer to portion size standards defined by the USDA: A standardgrain serving is one slice of white bread, one ounce of ready-to-eat cerealsor muffins, or one-half cup of rice or pasta. Therefore, a single bakerymuffin weighing 7 ounces, or one medium container of movie-theaterpopcorn (16 cups), easily meets or exceeds a day’s grain allowances.Larger servings of course contain more calories. The largest movie-theater soft drink contains 800 calories if not too diluted with ice. Largerportions can contribute to weight gain unless people compensate withdiet and exercise. From an industry standpoint, however, larger portionsmake good marketing sense. The cost of food is low relative to labor andother factors that add value. Large portions attract customers who flockto all-you-can-eat restaurants and order double-scoop ice cream conesbecause the relative prices discourage the choice of smaller portions. Itdoes not require much mathematical skill to understand that the largerportions of McDonald’s french fries are a better buy than the “small”when they are 40% cheaper per ounce.25

Taken together, advertising, convenience, larger portions, and (as weshall see) the added nutrients in foods otherwise high in fat, sugar, andsalt all contribute to an environment that promotes “eat more.” Becausedietary advice affects sales, food companies also conduct systematic, per-vasive, and unrelenting—but far less apparent—campaigns to convincegovernment officials, health organizations, and nutrition professionalsthat their products are healthful or harmless, to undermine any sugges-tion to the contrary, and to ensure that federal dietary guidelines andfood guides will help promote sales.

ISSUES AND THEMES

Overabundant food and its consequences occur in the context of increas-ing centralization and globalization of the food industry and of alteredpatterns of work, welfare, and government. The food system is only oneaspect of society, but it is unusual in its universality: Everyone eats.Because food affects lives as well as livelihoods, the situations discussed

26 . INTRODUCTION


in this book generate substantial attention from the industry and the gov-ernment, as well as from advocates, nutrition and health professionals,the media, and the public at large. In this book’s discussions of specifictopics and incidents, several themes occur. Some of these themes touchon matters central to the functioning of democratic institutions and areworth noting as they emerge in the chapters that follow.

One such theme is the “paradox of plenty,” the term used by historianHarvey Levenstein to refer to the social consequences of food overabun-dance, among them the sharp disparities in diet and health between richand poor.26 Wealthier people usually are healthier, and they choose bet-ter diets. They also tend to avoid smoking cigarettes, to drink alcohol inmoderation if at all, and to be better educated and more physically active.Health habits tend to cluster in patterns, making it difficult to tease outthe effects of diet from that of any other behavioral factor. Most para-doxical in the presence of food overabundance is that large numbers ofpeople in the United States and elsewhere do not have enough to eat. Theeconomic expansion of the twentieth century differentially favored peo-ple whose income was higher than average and provided much smallergains for the poor. As noted earlier, when people in developing countriesgo through a “nutrition transition,” they increase the intake of meat, fat,and processed foods, gain weight, and develop risk factors for diseases ofoverconsumption. In the United States, low-income groups seem to haveabout the same nutrient intake as people who are better off, but theychoose diets higher in calories, fat, meat, and sugar, and they displayhigher rates of obesity and chronic diseases. The income gap between richand poor can be explained by the functioning of economic and relatededucational systems. The gaps in diet and health are economically based,but they also derive in part from the social status attached to certainkinds of food—meat for the poor and health foods for the rich, for exam-ple. Food and beverage companies reinforce this gap when they seek newmarketing opportunities among minority groups or in low-income neigh-borhoods. The alcoholic beverage industry is especially adept in market-ing to “disenfranchised” groups.27

A second theme is the conflict between scientific and other kinds ofbelief systems. Although most scientists view scientific methods—testinghypotheses by controlled experiments—as inherently valid and truthful,we shall see that many people regard science as just one of a number ofbelief systems of equal validity and importance. Religious beliefs, con-cerns about animal rights, and views of the fundamental nature of soci-ety, for example, influence the way people think about food. So do vested

27 . INTRODUCTION


interests. Like any other kind of science, nutrition science is more a mat-ter of probabilities than of absolutes and is, therefore, subject to interpre-tation. Interpretation, in turn, depends on point of view. Governmentagencies invoke science as a basis for regulatory decisions. Food and sup-plement companies invoke science to oppose regulations and dietaryadvice that might adversely affect sales. Advocates invoke science toquestion the safety of products perceived as undesirable. In contrast, sci-entists and food producers, who might benefit from promoting researchresults, nutritional benefits, or safety, tend to view other-than-scientificpoints of view as inherently irrational. Debates about food issues thataffect broad aspects of society often focus on scientific proof of safetywhether or not safety constitutes the “real” issue, largely because alterna-tive belief systems cannot be validated by scientific methods.28

The third theme constitutes this book’s central thesis: diet is a politicalissue. Because dietary advice affects food sales, and because companiesdemand a favorable regulatory environment for their products, dietarypractices raise political issues that cut right to the heart of democraticinstitutions. Nearly all of the situations discussed in this book involvestruggles over who decides what people should eat and whether a givenfood is “healthy.” As a result, they inevitably involve struggles over theway government balances corporate against public interests. Such strug-gles are fundamental to the functioning of the American political system.They are revealed whenever a company attacks its critics as “food police”or justifies self-interested actions as a defense of freedom of choice orexclusion of “Big Brother” government from personal decisions. Theyare expressed whenever food companies use financial relationships withmembers of Congress, political leaders, and nutrition and health expertsto weaken the regulatory ability of federal agencies and whenever they goto court to block unfavorable regulatory decisions. Despite the over-whelmingly greater resources of food companies in defending their owninterests we shall see that consumer advocates sometimes can be highlyeffective in convincing Congress, federal agencies, and the courts to takeaction in the public interest. On that optimistic note, let’s begin by tracingthe history of federal dietary advice to the public and the ways in whichsuch advice has been influenced by the actions of the food industry.

28 . INTRODUCTION


Food Politics: How the Food Industry Influences Nutrition and Health, Revised and Expanded Tenth...

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